Order Form

Your Name________________________________________________________

Address___________________________________________________________

City,State & Zip____________________________________________________

Phone No________________________E-mail:__________________________

Shipping Charges:

1 to 6 tubers add $6.95                                      Sub total_______________

7 to 12 tubers add $9.95                                           S&H_______________

13 to 18 tubers add $12.25 and $.50                     Total_______________

For each additional tuber

Make Checks or Money Orders to Betty Nieman

Will you except substitutions:_________Yes or ___________No